Continuous Quality Improvement as a Management Concept for Death Investigation Systems

Abstract

Continuous quality improvement (CQI) represents a management technique where the basic approach to managing quality consists of setting a standard for a work process, measuring variation in the work process in relation to the standard, and then implementing programs to decrease variation and improve end results. Everyone providing a service becomes involved both in understanding how quality is measured and in discussing how to improve quality. A team approach is adopted and instead of focusing on poor quality outcomes and how to avoid them, the team becomes involved in setting continuously improving standards for better performance and in finding ways to meet those standards. The objective is to meet or exceed consumer or user expectations.Relevant related concepts such as survey research, needs determination and outcomes analysis, and the importance of a mission statement are discussed using a medical examiner system as an example.

Dissecting and Streamlining the Medical Record Acquisition Process in Death Investigation Systems

“…In order to investigate death, MDIs collect data from a variety of outside sources, including health records from hospitals and doctors' offices both within and outside of their jurisdiction (14, 16). For improved efficiency, data transmission should be fully integrated between MDI offices and the external organizations giving information to and receiving information from those offices (16). Due to technological, financial, and administrative challenges, this is often not the case (3, 10, 13).…”

“…Almost no peer-reviewed literature currently exists regarding the particular problem of record acquisition by MDI systems. Dibdin identified the flow of information through MDI systems as a potential area for continuous quality improvement, but did not focus on a specific area of need (16). Most literature focuses on the transmission of data either to the MDI office from laboratory services (14, 17), or from the MDI to public health instruments, such as surveillance databases (6, 12).…”